[unreadable] Pressure ulcers continue to be a serious secondary complication for people with impaired mobility and sensation. They affect older people and persons with many disabilities including spinal cord injury, multiple sclerosis, stroke, amputation and dementia. The cost in health care dollars to heal pressure ulcers, estimated to cost billions of dollars, is easily surpassed by the cost of ulcers measured in human terms, which can include loss of employment, independence and death. Pressure ulcers have been identified as a public health concern by the federal government via inclusion in Healthy People 2010 and by the National Quality Forum (NQF). Pressure ulcers develop in several ways, but their progression can be roughly grouped into two classes. Some ulcers begin superficially after ischemic damage to the epidermis and dermis. These ulcers begin as Stage I ulcers that are characterized by persistent erythema. Because erythema is hard to visualize in persons with dark skin, Blacks and dark skin Hispanics are at increased risk of ulcer development. The other type of pressure ulcer starts deep in tissue, typically at the level of an underlying bony prominence. This deep tissue injury goes undetected until it progresses toward the surface and presents as a bruising or discoloration. Both these etiologies of ulcers would greatly benefit from early detection. However, technology is currently unavailable to nurses and nurse assistants, who are typically charged with skin inspections. The overall goal of the project is the development and testing of imaging technology to be used in a clinically-affordable and portable device to identify incipient pressure ulcers and deep tissue injury. This erythema and deep tissue injury (E&DTI) detector will be used by healthcare practitioners who work with people who are at risk of developing pressure ulcers. The intended impact of the device is to enhance clinician visual assessment of skin to prevent the occurrence of pressure ulcers. A significant focus is on enhanced detection in people with darkly pigmented since, in whom visual inspection is problematic. [unreadable] [unreadable]